title: A 10-year review of otic lichen planus: the Mayo Clinic experience.
abstract: OBJECTIVE
  Lichen planus is an autoimmune inflammatory dermatosis that typically affects the skin but can also involve the stratified squamous epithelium of the external auditory canals and tympanic membranes. Here we report our experience with the clinical presentation, diagnosis, and management of otic lichen planus.
  
  
  METHODS
  We retrospectively reviewed medical records from January 1, 2001, through May 31, 2011, of patients with a diagnosis of otic lichen planus. Nineteen cases were identified (mean age at diagnosis, 57 years; 15 women). The most common concerns were persistent otorrhea and hearing loss. Other symptoms included plugging, pruritus, tinnitus, pain, and bleeding. The mean symptom duration was 4.0 years (n = 13). Most patients responded well to topical tacrolimus within several months. One patient had a dramatic positive response to rituximab.
  
  
  CONCLUSIONS
  Otic lichen planus can lead to persistent hearing loss and should be considered in the differential diagnosis of relentless otorrhea and external auditory canal stenosis. In our experience, topical tacrolimus is the best primary treatment, but alternative therapies could be instituted in severe cases. Early recognition of the nonspecific symptoms of otic lichen planus may lead to prompt treatment and avoidance of irreparable late sequelae.
authors.affiliation: Department of Dermatology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Julio C
authors.initials: JC
authors.lastname: Sartori-Valinotti
authors.forename: Alison J
authors.initials: AJ
authors.lastname: Bruce
authors.forename: Yulia
authors.initials: Y
authors.lastname: Krotova Khan
authors.forename: Charles W
authors.initials: CW
authors.lastname: Beatty
mesh_terms: D000328:Adult; D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004424:Ear Canal / Q000473:pathology*; D004427:Ear Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D034381:Hearing Loss / Q000209:etiology; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use; D008010:Lichen Planus / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D000069283:Rituximab; D016559:Tacrolimus / Q000008:administration & dosage / Q000627:therapeutic use; D016896:Treatment Outcome; D014432:Tympanic Membrane / Q000473:pathology*; D055815:Young Adult
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D007155:Immunologic Factors; D007166:Immunosuppressive Agents; D000069283:Rituximab; D016559:Tacrolimus